Study offers profile of 1889 flu pandemicThe influenza pandemic of 1889-90 spread around the world quickly and caused very high illness rates, but resulting fatality rates were similar to those of the 1957 and 1968 pandemics, according to a report by researchers who analyzed historical data from Europe and the United States. The study, by scientists from France's National Institute of Health and Medical Research and several other centers in Paris, was published early online by the Proceedings of the National Academy of Sciences (PNAS). The pandemic originated in Russia and took only 4 months to spread around the world, the report says. Data from 408 jurisdictions, most of them in Switzerland, yielded a median clinical attack rate (the proportion of the population with symptoms) of 60%. But case-fatality rates (CFRs), derived from data from the French, British, and German armies and from Swiss health records, ranged from 0.1% to 0.28%, similar to the rates in the 1957 and 1968 pandemics and roughly 10-fold lower than the CFR in the 1918 pandemic. The authors, who offer no data on the age distribution of cases or deaths, therefore describe the 1889 event as mild. The basic reproductive number (the number of additional cases triggered by each new case in a fully susceptible population) was estimated at 2.1, which is comparable to the other historical pandemics, the analysts say. They also found that the basic reproductive numbers for the 1889 and 1918 pandemic were correlated for cities for which both values were available, suggesting that social and geographic factors influence that variable.Apr 26 PNAS study abstract

CDC warns of dengue in Haiti relief workersThe Centers for Disease Control and Prevention (CDC) issued an e-mail health advisory today via its Health Alert Network for healthcare workers to be alert for symptoms of dengue in relief workers returning from Haiti. The agency has received reports of dengue fever among post-earthquake volunteers returning from Haiti, where the disease is endemic. The CDC urges healthcare providers to consider dengue in their differential diagnosis of febrile illness in anyone who has traveled in the past 30 days to Haiti or other countries where dengue transmission is occurring, and to submit samples to state health departments or the CDC Dengue Branch for lab testing. Relief workers responding to previous disasters in Haiti reported high rates of dengue. Dengue fever is characterized by high fever plus two or more of the following: headache, severe pain around the eyes, joint pain, muscle or bone pain, rash, low white blood cell count, and mild hemorrhagic symptoms such as nose or gum bleeding, petechiae, or easy bruising. The incubation period is typically 1 week but can range from 3 to 14 days. Most cases can be treated with bed rest, acetaminophen, and oral fluids. A small percentage of patients, however, can develop dengue hemorrhagic fever (DHF), a more serious manifestation that requires timely hospitalization.CDC dengue pageCDC public brief on dengue/DHF in Haiti

Non-O157 E coli outbreak reported in Michigan, OhioAt least a dozen people in Ohio and Michigan, including some students from Ohio State University and the University of Michigan, have gotten sick from a non-O157 strain of Escherichia coli, the Columbus (Ohio) Dispatch reported today. Twenty other people are being tested for possible cases of the same illness, for which no source has been found. In a news release yesterday, Columbus Public Health said it had received reports of five cases of E coli non-O157, two of which have been matched to cases in Michigan. The Dispatch report said Columbus officials were investigating six other possible cases. The story also said Michigan officials had confirmed seven cases in the Ann Arbor area and were looking into 14 others. All of the patients became ill between Apr 9 and 15. Some patients in both Ohio and Michigan were hospitalized, but none have had hemolytic uremic syndrome, a potentially fatal complication, the newspaper reported.Apr 26 Columbus Public Health releaseApr 27 Columbus Dispatch report